The Little TPA with
Big Ideas
We don’t just pay claims
We make sure they are accurate
We are the TPA that does more
We go above and beyond claim management by proactively verifying place-of-service details, detecting billing errors, and recovering overpayments that could otherwise cost plans thousands—or even millions—per year. Your members get the quality healthcare they deserve and you get peace-of-mind knowing that the bill was accurate.
What are Place-of-Service Errors?
NEW WHITE PAPER
The Ultimate Guide on Place-of-Service Errors
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What is your current TPA doing to help you save on healthcare?
Complaining about healthcare does nothing. Waterfront Healthcare, on the other hand, is first TPA for self-funded health plans to address the problem of place-of-service errors. By combining customer service capabilities with claims audit techniques, we engage with members and identify errors. Your members get the quality healthcare they deserve and you get peace-of-mind knowing that the bill was accurate.
1 in 3 Claims Dollars
A landmark study by HHS observed 37 physicians and 83 hospitals over 33 months and what they found was shocking: 29.7% of all dollars billed had incorrect place-of-service coding. [1]
[1] U.S. Department of Health and Human Services (hhs.gov)
Why This Matters
Detecting and correcting these errors is a great way to save money. A single place-of-service error alone can cost a self-funded plan thousands of dollars. Over a fiscal year, a self-funded health plan could be losing millions.
Our Solution
We combine world-class customer service with claims auditing to connect with members and verify the correct place-of-service. Meanwhile, our AI works behind the scenes to help predict where errors are likely to occur.
TPA Services
Offering third-party administration for self-insured group health plans with unmatched value-add features like place-of-service verification
Who We Are
We understand the burden of increasing healthcare spending and we want to take action
Who We Help
We work with insurance brokers and consultants and small to medium-sized self-funded health plans
